Friday, May 8, 2009

Just Say "No"...

...As in, "Fresno."

There is a reason that there is a lot of back-and-forth going on between SEIU and NUHW regarding the Fresno County IHSS (In-Home Support Services) providers, the main reason being that there is an upcoming vote (ballots go out in the first week of June), and this will be the first major showdown between SEIU and NUHW over representation. At stake is the representation of some 10,000 individuals who provide in-home support to elderly and disabled persons in Fresno and its surrounding communities.

In the runup to those elections, both NUHW and SEIU have been paying great attention to some of the budgetary concerns that are surrounding things like in-home support services. These services are mandated by the federal CMS (which administers MediCare and Medicaid), and county bean-counters have been trying every which-way to save money on the portion that they are required to pay for those services.

Recently, Fresno County was called onto the carpet by an arbitrator for voting to cut IHSS caregiver wages by something on the order of $1.10 an hour. When SEIU reacted to that decision, their approach was something we all have seen and heard before - they blamed another union for the problem having presented itself in the first place, and then decided in that same presser to threaten the current IHSS workers that their contract would become "null and void" should they sign with NUHW. But of course, nowhere is there anything seen about anything concrete that SEIU would actually do for those workers, or what they have actually done for those workers. Nothing has been heard from SEIU in regards to Fresno IHSS workers since that last presser in late April blaming NUHW and its leadership for all the woes in the world.

We contrast that approach with the recent activity seen by NUHW and its supporters, as can be seen here...
Over a hundred Fresno homecare providers packed the Fresno County Board of Supervisors on Tuesday to oppose an agenda item that would reduce their wages and benefits to $9.50 an hour. But they weren’t just there to protest the wage cuts—they also pointed to the repeated failure of their union, SEIU, to support them in stopping the cuts.

“SEIU just failed to stop a different set of cuts last week,” said Flo Furlow, a homecare worker. “Now the county wants to cut our wages even more, and this time SEIU isn’t even going to take it to arbitration. How many times can we let this happen?”

Providers wages are paid by In-Home Supportive Services, a service that saves tax dollars by allowing people with long-term medical needs to receive care in their own homes rather than in more costly nursing homes. It is funded jointly by the County, the State, and the federal government.

Despite pleas from homecare providers and their consumers, Supervisors voted 3 to 2 to submit a “rate request” packet to the California Department of Social Services—an administrative step that would allow the cuts to take effect starting July 1.

When Fresno County first began seeking cuts in September, homecare workers and their elected union leaders successfully organized to stop the cuts from taking effect. That work ground to a halt in January, when national SEIU officials took over California’s healthcare union in order to force homecare workers into a separate union that would be run by SEIU staff from Washington, D.C. SEIU removed the rank-and-file leaders that Fresno homecare workers had elected to represent them.

Ordinarily that would be seen as bad news - NUHW would be seen as having failed in its effort to stop the cuts. Fortunately, unlike SEIU, NUHW actually decided to fight those cuts - and got a memo from the Center for Medicare/Medicaid Services (the folks who actually determine what gets paid in Medicare/Medicaid) indicating that the State of California's cuts (and through them, Fresno County's cuts) were not in line with the recent Recovery Act passed by Congress...

The Obama administration’s Centers for Medicare and Medicaid Services (CMS) has outlined a position that California’s cuts to state funding for In-Home Supportive Services (IHSS) are out of compliance with the requirements of the federal Recovery Act (known formally as the American Recovery and Reinvestment Act or ARRA) for receiving enhanced Medicaid funding. The Recovery Act prohibits a state from receiving the Act’s additional Medicaid funds if the state increases local governments’ share of the cost of the Medicaid program.

The position, set forth in a memo provided to state lawmakers earlier this week, makes clear that the homecare cuts in next year’s state budget are vulnerable to legal challenge, and that California could lose billions of dollars in enhanced Medicaid funding for a wide variety of healthcare programs between July 1, 2009 and December 31, 2010 if homecare services are not restored to prior levels.

The memo states that, “CMS believes the limitation [on state contributions for personal care services] would violate the ARRA local contribution MOE [Maintenance of Effort requirement],” based on findings that California’s homecare cuts would improperly require county governments to pay a higher share of cost for the IHSS program. While the memo notes that the state could make IHSS cuts without violating the requirements of the Recovery Act by directly reducing homecare provider rates rather than reducing the state share of cost for them, such a policy would literally lock workers into poverty, preventing counties from funding wages and benefits at levels necessary to provide reliable, quality care, even if local governments wanted to increase their own funding of the program. Such a policy would also force consumers, caregivers, and communities to forgo huge amounts of available federal funding.

NUHW leaders and staff were the first to raise the possibility of a legal challenge to proposed IHSS cuts under the Recovery Act’s local contribution Maintenance of Effort requirement months ago, immediately after it was added to the bill by the U.S. Senate.

SEIU's reaction to the above?




We'll let you know when it comes out.

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